Emilia A Hermann1, Amin Motahari2, Eric A Hoffman2, Norrina Allen3, Alain G Bertoni4, David A Bluemke5, Ali Eskandari2, Sarah E Gerard2, Junfeng Guo2, Grant T Hiura1, David W Kaczka2, Erin D Michos6, Prashant Nagpal2,5, Jim Pankow7, Sanjiv Shah3, Benjamin M Smith1, Karen Hinckley Stukovsky8, Yifei Sun9, Karol Watson10, R Graham Barr1,11. 1. Department of Medicine, Columbia University Medical Center, New York, NY (E.A.H., G.T.H., B.M.S., R.G.B.). 2. University of Iowa, Iowa City (A.M., E.A.H., A.E., S.E.G., J.G., D.W.K., P.N.). 3. Northwestern University, Evanston, IL (N.A., S.S.). 4. Wake Forest School of Medicine, Winston-Salem, NC (A.G.B.). 5. University of Wisconsin-Madison (D.A.B., P.N.). 6. Johns Hopkins University, Baltimore, MD (E.D.M.). 7. University of Minnesota, Minneapolis (J.P.). 8. University of Washington, Seattle (K.H.S.). 9. Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York (Y.S.). 10. University of California, Los Angeles (K.W.). 11. Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York (R.G.B.).
Abstract
BACKGROUND: The pulmonary vasculature is essential for gas exchange and impacts both pulmonary and cardiac function. However, it is difficult to assess and its characteristics in the general population are unknown. We measured pulmonary blood volume (PBV) noninvasively using contrast enhanced, dual-energy computed tomography to evaluate its relationship to age and symptoms among older adults in the community. METHODS: The MESA (Multi-Ethnic Study of Atherosclerosis) is an ongoing community-based, multicenter cohort. All participants attending the most recent MESA exam were selected for contrast enhanced dual-energy computed tomography except those with estimated glomerular filtration rate <60 mL/min per 1.73 m2. PBV was calculated by material decomposition of dual-energy computed tomography images. Multivariable models included age, sex, race/ethnicity, education, height, weight, smoking status, pack-years, and scanner model. RESULTS: The mean age of the 727 participants was 71 (range 59-94) years, and 55% were male. The race/ethnicity distribution was 41% White, 29% Black, 17% Hispanic, and 13% Asian. The mean±SD PBV in the youngest age quintile was 547±180 versus 433±194 mL in the oldest quintile (P<0.001), with an approximately linear decrement of 50 mL per 10 years of age ([95% CI, 32-67]; P<0.001). Findings were similar with multivariable adjustment. Lower PBV was associated independently with a greater dyspnea after a 6-minute walk (P=0.04) and greater composite dyspnea symptom scores (P=0.02). Greater PBV was also associated with greater height, weight, lung volume, Hispanic race/ethnicity, and nonsmoking history. CONCLUSIONS: Pulmonary blood volume was substantially lower with advanced age and was associated independently with greater symptoms scores in the elderly.
BACKGROUND: The pulmonary vasculature is essential for gas exchange and impacts both pulmonary and cardiac function. However, it is difficult to assess and its characteristics in the general population are unknown. We measured pulmonary blood volume (PBV) noninvasively using contrast enhanced, dual-energy computed tomography to evaluate its relationship to age and symptoms among older adults in the community. METHODS: The MESA (Multi-Ethnic Study of Atherosclerosis) is an ongoing community-based, multicenter cohort. All participants attending the most recent MESA exam were selected for contrast enhanced dual-energy computed tomography except those with estimated glomerular filtration rate <60 mL/min per 1.73 m2. PBV was calculated by material decomposition of dual-energy computed tomography images. Multivariable models included age, sex, race/ethnicity, education, height, weight, smoking status, pack-years, and scanner model. RESULTS: The mean age of the 727 participants was 71 (range 59-94) years, and 55% were male. The race/ethnicity distribution was 41% White, 29% Black, 17% Hispanic, and 13% Asian. The mean±SD PBV in the youngest age quintile was 547±180 versus 433±194 mL in the oldest quintile (P<0.001), with an approximately linear decrement of 50 mL per 10 years of age ([95% CI, 32-67]; P<0.001). Findings were similar with multivariable adjustment. Lower PBV was associated independently with a greater dyspnea after a 6-minute walk (P=0.04) and greater composite dyspnea symptom scores (P=0.02). Greater PBV was also associated with greater height, weight, lung volume, Hispanic race/ethnicity, and nonsmoking history. CONCLUSIONS: Pulmonary blood volume was substantially lower with advanced age and was associated independently with greater symptoms scores in the elderly.
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